Executive function is a broad group of mental skills that enable people to complete tasks and interact with others. Disordered executive function can impair a person’s ability to organize and manage behavior.
Executive function disorder is not a specific stand-alone diagnosis or condition. Instead, neurological, mental health, and behavioral disorders, such as depression and attention deficit hyperactivity disorder (ADHD), can affect a person’s executive function.
Occasionally, healthcare professionals may refer to disordered executive function as executive dysfunction.
Executive function skills help people complete tasks and interact with others. They include a range of skills, such as:
- planning and organization
- concentrating and managing mental focus
- analyzing and processing information
- managing emotions and behavior
- remembering details
- managing time
- solving problems
An executive function disorder impairs some of these skills, which can affect a person’s ability to manage and organize themselves to achieve goals.
However, the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) does not recognize executive function disorder as a specific mental health condition. Instead, executive function issues are symptomatic of other neurological, mental health, and behavioral disorders.
For example, depression may affect certain executive functions, such as memory, attention, and management of inhibitions. Alzheimer’s disease can also sometimes severely impair executive function to a point where a person may no longer be able to drive, get dressed, or behave appropriately in social situations.
People with executive function issues may have the following symptoms:
- trouble managing emotions or impulses
- problems with starting, organizing, planning, or completing tasks
- trouble listening or paying attention
- short-term memory issues
- inability to multitask or balance tasks
- socially inappropriate behavior
- inability to learn from past consequences
- difficulty solving problems
- difficulty learning or processing new information
Problems with executive function may lead to:
- affected performance at work or school
- difficulty forming or maintaining relationships
- mood issues
- low self-esteem
- avoidance of difficult tasks
- low motivation or loss of interest in activities
Executive function takes time to develop, so many of these behaviors are typical in young children. However, if these behaviors persist, they may indicate that the child has difficulty with executive function.
ADHD is a neurodevelopmental impairment of executive function that can cause hyperactivity, impulsivity, and inattention.
Symptoms of ADHD can vary in type and severity, but may
- fidgeting, restlessness, being unable to sit still, and talking excessively
- acting without thinking and behaving in socially inappropriate ways
- often interrupting other people’s conversations or activities
- being prone to distraction or having a short attention span
- making careless mistakes at work or in schoolwork
- having difficulty organizing, completing, or focusing on tasks
- general forgetfulness
People with executive function issues may have ADHD. However, ADHD is not the only condition that can affect executive function.
Conditions that can cause executive function issues include:
- depression and anxiety
- bipolar disorder
- obsessive-compulsive disorder (OCD)
- Alzheimer’s disease, frontotemporal dementia, and Lewy body dementia
- Tourette syndrome
- traumatic injuries to the brain
Temporary causes of executive function issues can include:
- severe pain
- distracting environments
Doctors can use a variety of tests to help assess a person’s executive function.
For example, in the Stroop color and word test, a person looks at the names of colors that appear in different colored inks. So the word “red” may appear in green ink, and the word “yellow” may appear in blue ink. For each word, the person has to say what the ink color is rather than the written color name. This test can help evaluate a person’s mental management and selective attention.
Other tests that a doctor may use to assess executive function include:
- trail making
- clock drawing
- verbal fluency
- card sorting
If a doctor suspects a specific disorder, such as ADHD, they may skip executive functioning tests and instead compare the person’s symptoms with standard diagnostic criteria for that disorder.
The type of treatment will depend on the condition causing the executive function issues.
Some neurological disorders, particularly dementia, are progressive. Although some treatments may help slow the disease, symptoms may become more severe over time.
However, many causes of executive function issues are highly treatable.
Treatment options may include:
Executive function is a set of mental skills that help people plan, organize, manage their time, pay attention, process information, and manage their behavior. Executive function issues can affect everything from how a person interacts with other people to their ability to learn and work.
A common cause of executive function issues is ADHD, but other causes can include dementia, depression, schizophrenia, autism, and traumatic injuries to the brain.
Diagnosing the cause of executive function issues can help identify treatment options, such as medications and therapy. Signs of executive function issues include chronic disorganization, lack of focus, memory problems, and socially inappropriate behavior.